Print Email Facebook Twitter Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis Title Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis Author Rosman, A.N. Vlemmix, F. Beuckens, A. Rijnders, M.E. Opmeer, B.C. Mol, B.W.J. Kok, M. Fleuren, M.A.H. Publication year 2014 Abstract OBJECTIVE: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands.DESIGN: national online survey.SETTING: the Netherlands. PARTICIPANTS: gynaecologists and midwives.MEASUREMENTS: in the online survey, we identified the determinants that positively or negatively influenced the professionals׳ adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline.FINDINGS: 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence.KEY CONCLUSIONS: self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV.IMPLICATIONS FOR PRACTICE: to improve adherence to the guidelines on ECV we must improve self-efficacy. Subject Behavioural ChangesCH - Child Health LS - Life StyleELSS - Earth, Life and Social SciencesHealthy for LifeHealthHealthy LivingDeterminantsExternal cephalic versionGuidelinesImplementation To reference this document use: http://resolver.tudelft.nl/uuid:57505f45-c356-4bab-8f30-d424e26b270d DOI https://doi.org/10.1016/j.midw.2014.01.002 TNO identifier 492692 Source Midwifery, 30 (3), 145-150 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.